Etiopatogenesis and possibilities of minimally invasive diagnostics of liver cirrhosis: literature review

Cover Page

Cite item

Full Text

Abstract

Liver cirrhosis (LC) remains a significant socio-economic problem of healthcare worldwide and has the highest mortality rate among nonneoplastic diseases of the digestive system. The most common etiological factors are alcoholic liver disease, chronic viral hepatitis, and non-alcoholic fatty liver disease. General pathological mechanisms are involved in the pathogenesis of cirrhosis: damage, necrosis and steatosis of hepatocytes, inflammation with the production of pro-inflammatory cytokines, endothelial dysfunction, oxidative stress, metabolic disorders, fibrosis activation, pathological regeneration, neoangiogenesis, impaired organ architectonics with the development of portal hypertension and hemostasis disorders. At the present stage, the diagnosis of cirrhosis is based on laboratory, instrumental, morphological research methods and calculated indices. In the diagnosis of liver cirrhosis, combinations of various tests can be used, which reflect the pathogenetic mechanisms of liver damage. Optimization of known and creation of new approaches to the differential diagnostics of the severity of cirrhosis makes it possible to carry out timely therapeutic measures aimed at preventing the progression of this disease.

About the authors

S. V. Paducheva

City Clinical Hospital № 2 named after F.Kh. Gral

Author for correspondence.
Email: paducheva_sv@mail.ru

Candidate of Medical Sciences, Head of the Clinical Diagnostic Laboratory

Russian Federation, Perm

References

  1. Ivashkin V.T., Maevskaya M.V., Zharkova M.S., Zhigalova S.B., Kitsenko E.A., Manuk'yan G.V., Trukhmanov A.S., Maev I.V., Tikhonov I.N., Deeva T.A. Clinical Recommendations of the Russian Scientific Liver Society and Russian Gastroenterological Association on Diagnosis and Treatment of Liver Fibrosis, Cirrhosis and Their Complications. Rossiyskiy zhurnal gastroenterologii, gepatologii, koloproktologii 2021; 31 (6): 56–102 (in Russian).
  2. Zhmurov D.V., Parfenteva M.A., Semenova Yu.V., Rubtsov D.A. Cirrhosis of the liver. Colloquium-journal 2020; 63 (11): 40–45 (in Russian).
  3. Sepanlou S.G., Safiri S., Bisignano C. et al. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol. Hepatol. 2020; 5 (3): 245–266.
  4. Tsukanov V.V., Vasyutin A.V., Tonkikh Yu.L. New aspects of non-alcoholic fatty liver disease. Doktor. Ru 2021; 20 (4): 33–39 (in Russian).
  5. Yushchuk N.D., Znoyko O.O., Dudina K.R. Belyy P.A. The problem of viral hepatitis C in the Russian Federation. Terapevticheskiy arkhiv 2014; 10: 7 7–81 (in Russian).
  6. Shchekotova A.P. Cirrhosis of the liver. Permskiy meditsinskiy zhurnal 2022; 39 (4): 41–57 (in Russian).
  7. Pavlov A.I. Alcoholic liver disease diagnosis and treatment in a multidisciplinary hospital. Effektivnaya farmakoterapiya 2013; 41: 30–37 (in Russian).
  8. Shchekotova A.P., Bulatova I.A. Paducheva S.V. Clinical and diagnostic problems of liver fibrosis/cirrhosis. Permskiy meditsinskiy zhurnal 2018; 35 (5): 98–108 (in Russian).
  9. Kucheryavyy Yu.A., Stukova N.Yu., Akhtaeva M.L. Chronic hepatitis, liver cirrhosis and hepatocellular carcinoma are links in the same chain. Klinicheskie perspektivy gastroenterologii i gepatologii 2012; 5: 3–11, available at: https://www.elibrary.ru/item.asp?id=17953527 (in Russian).
  10. Bulatova I.A. Fibrosis in chronic liver diseases: mechanisms of development, clinical and laboratory assessment of progression and therapy monitoring: avtoref. dis. … d-ra med. nauk. M., 2016, available at: https://www.elibrary.ru/item.asp?id = 30436863&ysclid = lgafiurjvv543644882 (in Russian).
  11. Paducheva S.V. Clinical and diagnostic significance of inflammatory and molecular genetic. Indicators for cirrhosis of the liver. 14.01.04. Vnutrennie bolezni Avtoreferat. dissertatsii na soiskanie uchenoy stepeni kandidata meditsinskikh nauk. Perm'. 2019, available at: https://psma.ru/index.php?option = com_mtree&task=att_download&link_id = 255&cf_id = 56&ysclid = lgafo5z7n0872158741 (in Russian).
  12. Bulatova I.A., Miftakhova A.M., Gulyaeva I.L. The severity of the inflammatory response and endothelial dysfunction in non-alcoholic steatosis and liver fibrosis of viral origin. Permskiy meditsinskiy zhurnal 2021; 38 (4): 54–61 (in Russian).
  13. Shchekotova A.P., I.A. Bulatova I.A., S.V. Paducheva S.V. Hepatic Syndromes and Cytokine Parameters in Patients with Liver Cirrhosis. Permskiy meditsinskiy zhurnal 2019; 36 (5): 27–34 (in Russian).
  14. Gulyaeva I.L., Pestrenin L.D. Logunov A.V., Bulatova I.A. Pathology of hemostasis and endothelial dysfunction in hepatitis B: state of the art. Tromboz, gemostaz i reologiya 2017; 75 (4): 14–19 (in Russian).
  15. Shchekotov V.V., Shchekotova A.P., Bulatova I.A. Relationship between markers of endothelial dysfunction and fibrosis in chronic hepatitis and liver cirrhosis. Klinitsist 2011; 5 (3): 68–72 (in Russian).
  16. Bulatova I.A., Shchekotova A.P., Paducheva S.V. The role of inflammation and iron metabolism disorders in the progression of liver cirrhosis. Permskiy meditsinskiy zhurnal 2021; 38 (1): 38–46 (in Russian).
  17. Shchekotova A.P., Bulatova I.A. The role of vasculoendothelial growth factor and its gene in the pathogenesis of hepatobiliary pathology. Permskiy meditsinskiy zhurnal 2020; 37 (4): 36–45 (in Russian).
  18. Bulatova I.A., Shchekotova A.P., Karlysheva K.N., Shul'kina S.G., Kalugina E. Leptin, pro-inflammatory cytokines, and liver function tests in fatty liver metabolic syndrome. Permskiy meditsinskiy zhurnal 2014; 31 (2): 86–91, available at: https://journals.eco-vector.com/PMJ/article/view/3249/2869?ysclid=lgagaagf3j600683411 (in Russian).
  19. Bulatova I.A., Shchekotova A.P., Suzdal'tseva K.N., Shchekotov V.V., Ulitina P.V., Zhizhilev E.V. Superoxide dismutase and glutathione reductase in chronic hepatitis C and non-alcoholic fatty liver disease. Fundamental'nye issledovaniya 2014; 7 (3): 455–459, available at: www.rae.ru/fs/?section=content&op = show_article&article_id = 10003729 (in Russian).
  20. Gulyaeva I.L., Bulatova I.A., Pestrenin L.D. Characteristics of indicators of the hemostasis system in patients with fibrosis and cirrhosis of the liver. Eksperimental'naya i klinicheskaya gastroenterologiya 2018; 156 (8): 21–24 (in Russian).
  21. Bulatova I.A., Tret'yakova Yu.I., Shchekotov V.V., Shchekotova A.P., Ulitina P.V., Krivtsov A.V., Nenasheva O.Yu. Catalase gene rs1001179 polymorphism and oxidative stress in patients with chronic hepatitis C and ulcerative colitis. Terapevticheskiy arkhiv.2015; 87 (2): 49–53 (in Russian).
  22. Bulatova I.A., Shevlyukova T.P., Shchekotova A.P., Paducheva S.V., Martynov A.I. Polymorphism of cytokine genes in patients with liver cirrhosis. Terapiya 2022; 5: 47–52 (in Russian).
  23. Bulatova I.A., Shevlyukova T.P., Shchekotova A.P., Krivtsov A.V. Genetic profile of patients with chronic hepatitis C. Patologicheskaya fiziologiya i eksperimental'naya terapiya 2022; 66 (1): 35–43 (in Russian).
  24. Bulatova I.A., Shevlyukova T.P., Shchekotova A.P., Krivtsov A.V. The presence of CAT genetic markers indicates an accelerated rate of progression of liver fibrosis in patients with chronic hepatitis. Eksperimental'naya i klinicheskaya gastroenterologiya 2021; 189 (5): 39–43 (in Russian).
  25. Dirchwolf М., Ruf А. Role of systemic inflammation in cirrhosis: From pathogenesis to prognosis. J. Hepatol 2015; 8: 1974–1981.
  26. Robinson M., Harmon С., O’Farrell С. Liver immunology and its role in inflammation and homeostasis. Cellular & Molecular Immunology 2016; 13: 267–276.
  27. Albillos A., Lario М., Alvarez-Mon М. Cirrosis-associated immune distinctive features and clinical relevance. J Hepatol 2014; 61 (6): 1385–96.
  28. Claria J., Stauber R.E., Coenraad M.J., Moreau R., Jalan R., Pavesi M., Amoros A., Titos E., Alcaraz-Quiles J., Oettl K., Morales- Ruiz M., P. Angeli. Systemic inflammation in decompensated cirrhosis: Characterization and role in acute-on-chronic liver failure. Hepatology 2016; 64 (4): 1249–1264.
  29. Shchekotova A.P., Krivtsov A.V., Bulatova I.A., Zagorodskikh E.B. Endothelial dysfunction and endothelial nitric oxide synthase (NOS3) gene polymorphism in chronic liver diseases. Sovremennye problemy nauki i obrazovaniya. 2012; 2: 109, available at: https://science-education.ru/ru/article/view?id = 6047 (in Russian).
  30. Martmez-Esparza М., Tristan-Manzano M., Ruiz-Alcaraz A.J., Garda-Penarrubia Р. Inflammatory status in human hepatic cirrhosis. J. Gastroenterol 2015; 41 (21): 11522–11541.
  31. Bazarnyy V.V., Garenskikh N.V. Problems of laboratory diagnosis of liver cirrhosis. Novosti «Vektor Best» 2013; 67 (1): 9–11, available at:: // /C: /Users/User/Downloads/n67.pdf (in Russian).
  32. Europian Association for the Study of the Liver. Background media infomation, Fast facts about liver disease 2016; available at: www.2016.ilc%congress.eu/wp/%content/uploads/2016/04/Liver%disease%backgrounder.pdf
  33. Pinzani M., Rombouts К., Colagrande S. Fibrosis in chronic liver diseases: diagnosis and management. J Hepatol. 2005; 42: 22–36.
  34. Sherlok Sh., Duli Dzh. Diseases of the liver and biliary tract: praktich. ruk. Per. s angl. Pod red. Z.G. Aprosinoy, N.A. Mukhina. Moscow: GEOTAR-MED 2002; 864.
  35. Poynard T., Munteanu M., Imbert Bismut F., Charlotte F., Thabut D., Le Calvez S.l. Prospective analysis of discordant results between biochemical markers and biopsy in patients with chronic hepatitis C. Clin Chem 2004; 10: 10.
  36. Child C.G., Turcotte J.G. Surgery and portal hypertension. Major Probl Clin Surg. 1964, 1: 1–85. PMID: 4950264.
  37. Wai C-T., Greenson К., Fontana R.J. et al. A simple noninvasive index can predict both signifi cant fi brosis and cirrhosis in patients with chronic hepatitis C. Hepatology 2003; 38 (2): 518–26.
  38. Williams A.L., Hoofnagle J.H. Ratio of serum aspartate to alanine aminotrans % ferase in chronic hepatitis. Relationship to cirrhosis. Gastroenterology 1988; 95 (3): 734–739.
  39. Bulatova I.A., Dolgikh O.V., Paducheva S.V. Shchekotova A.P., Shelud'ko V.S. Method for diagnosing the severity of liver cirrhosis of mixed etiology. Patent na izobretenie № 2632101 от 02.10.2017. po zayavke № 2016117613 ot 04.05.2016 g. Byul. № 28, available at: https://yandex.ru/patents/doc/RU2632101C1_20171002?ysclid = lgameefgyw424912136 (in Russian).
  40. Pestrenin L.D., Bulatova I.A., Gulyaeva I.L., Shelud'ko V.S., Miftakhova A.M. Sposob diagnostiki klassa tsirroza pecheni. Patent na izobretenie 2766768 C1 ot 15.03.2022. Zayavka № 2021115015 ot 25.05.2021, available at: https://yandex.ru/patents/doc/RU2766768C1_20220315?ysclid = lgamlklcca697325591 (in Russian).
  41. Bulatova I.A., Shevlyukova T.P. Assessment of the diagnostic significance of calculated indices for determining the class of liver cirrhosis. Eksperimental'naya i klinicheskaya gastroenterologiya 2022; 7 (203): 31–37 (in Russian).
  42. Gavrilenko D.I., Silivonchik N.N. Assessment of the diagnostic significance of the CLIF-C scale for predicting in-hospital mortality in patients with liver cirrhosis and bacterial infections. Lechebnoe delo: Nauchno-prakticheskiy terapevticheskiy zhurnal 2015; 43 (3): 46–48 (in Russian).
  43. Gana J.C., Turner D., Roberts E.A., Ling S.C. Derivation ofa clinical predictionrule for the noninvasive diagnosis of varices in children. J Pediatr Gastroenterol Nutr. 2010; 50 (2): 188–193.
  44. Park S.H., Park T.E., Kim Y.M., Kim S.J., Baik G.N., Kim J.B., Kim D.J. Non-invasive model predicting clinically signifi cant portal hypertension in patients with advanced fi brosis. J Gastroenterol Hepatol. 2009; 24 (7):. 1289–1293.
  45. Jalan R., Saliba F., Pavesi M., et al. CANONIC study investigators of the EASL–CLIF Consortium. Development and validation of a prognostic score to predict mortality in patients with acute-on-chronic liver failure. J Hepatol. 2014; 61 (5): 1038–1047.
  46. Stewart Sell M.D., David Stillman B.S., Nathan Gochman B.S. Serum alpha fetoprotein: a prognostic indicator of liver cell necrosis and regeneration following experimental injury by calactosamine in rats. American. Journal of Clinical Pathology 1976; 5: 847–853.
  47. Rachkovskiy M.I., Beloborodova E.V., Sinicheva Yu.I. Predicting the onset of lethal outcome in patients with liver cirrhosis of viral and alcoholic etiology. Sibirskiy meditsinskiy zhurnal. 2012; 115 (8): 20–23, available at: https://mir.ismu.baikal.ru/src/downloads/1f94e887_2012-8_s_oblozhkoiy.pdf (in Russian).
  48. Zhu Shao Ming M.D., Waili Yulituzi M.D., Qi XiaoTing M.D., Chen YueMei M.D., Lou YuFeng M.D. Serum C reactive protein predicts early mortality in hospitalized patients with HBV related decompensated cirrhosis. Chen Medicine 2017; 96 (4): 5988.
  49. Shchekotova A.P, Bulatova I.A., Roytman A.P. Sensitivity and specificity of determination of hyaluronic acid, de Ritis coefficient and VEGF for the diagnosis of CG and cirrhosis. Permskiy meditsinskiy zhurnal 2013; 30 (4): 84–89, available at: https://www.elibrary.ru/item.asp?id = 20226896&ysclid = lganozikru577796415 (in Russian).
  50. Wynn А. Cellular and molecular mechanisms of fibrosis. J Pathol. 2008; 214: 199–210.
  51. EASL Clinical Practice Guidelines: Management of alcoholrelated liver disease. Journal of Hepatology 2018; (69): 154–181.

Copyright (c) 2023 Paducheva S.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies